Reliability and Validity of the Thai Version of the PAINAD Scale: An Extended Application of Pain Assessment in the Moderately Severe Stage of Dementia

Objective: To evaluate the reliability and validity of the Thai version of the PAINAD (PAINAD-Th) scale for assessing pain in people with dementia (PwD). Materials and methods: A cross-cultural translation of the PAINAD scale involving forward and back-translation to and from Thai was conducted,...

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Main Authors: Natthapapath Boonsawat, Patumporn Suraarunsumrit, Sutisa Pitiyarn, Napaporn Pengsorn, Varalak Srinonprasert, Sahatsa Mandee, Titima Wongviriyawong
Format: Article
Language:English
Published: Faculty of Medicine Siriraj Hospital 2025-01-01
Series:Siriraj Medical Journal
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Online Access:https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/271644
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author Natthapapath Boonsawat
Patumporn Suraarunsumrit
Sutisa Pitiyarn
Napaporn Pengsorn
Varalak Srinonprasert
Sahatsa Mandee
Titima Wongviriyawong
author_facet Natthapapath Boonsawat
Patumporn Suraarunsumrit
Sutisa Pitiyarn
Napaporn Pengsorn
Varalak Srinonprasert
Sahatsa Mandee
Titima Wongviriyawong
author_sort Natthapapath Boonsawat
collection DOAJ
description Objective: To evaluate the reliability and validity of the Thai version of the PAINAD (PAINAD-Th) scale for assessing pain in people with dementia (PwD). Materials and methods: A cross-cultural translation of the PAINAD scale involving forward and back-translation to and from Thai was conducted, and then the content validity index (CVI) of semantic equivalence was evaluated. The PAINAD-Th was tested on 120 videos of PwD. Each participant was recorded in two videos: one during an activity and the other at rest. Subsequently, two trained nurses independently observed the videos and rated the PAINAD-Th to assess inter-rater reliability. The rating process was repeated in one week to investigate the test-retest reliability. The concurrent validity was assessed against the Visual Analogue Scale rated by the expert committee. Results: The CVI of PAINAD-Th was 1.00 for forward translation and 0.93 for back translation. The PAINAD-Th showed strong correlations with the reference standard (rs=0.854–0.943, p-value <0.001). The inter-rater agreement for the total scores was 0.937 and 0.955, and the test-retest reliabilities were 0.914 to 0.964 for the activity stage and 0.880 for the resting stage, respectively. The concurrent validity index did not vary significantly across different stages of dementia; the findings remained consistent in the delirium subgroup analysis. Conclusions: The PAINAD-Th is a valuable tool for evaluating pain in PwD, not only in severe dementia but also in moderately severe stage, regardless of concurrent delirium. It also demonstrated good-to-excellent concurrent validity, inter-rater reliability, and test-retest reliability.
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spelling doaj-art-7d23bf24bfc3448a918cb3984c412fc12025-01-01T07:36:21ZengFaculty of Medicine Siriraj HospitalSiriraj Medical Journal2228-80822025-01-0177110.33192/smj.v77i1.271644Reliability and Validity of the Thai Version of the PAINAD Scale: An Extended Application of Pain Assessment in the Moderately Severe Stage of DementiaNatthapapath Boonsawat0Patumporn Suraarunsumrit1Sutisa Pitiyarn2Napaporn Pengsorn3Varalak Srinonprasert4Sahatsa Mandee5Titima Wongviriyawong6Division of Geriatric Medicine, Department of Medicine, Khon Kaen Hospital, Khon Kaen, Thailand; Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDepartment of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDepartment of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDivision of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand Objective: To evaluate the reliability and validity of the Thai version of the PAINAD (PAINAD-Th) scale for assessing pain in people with dementia (PwD). Materials and methods: A cross-cultural translation of the PAINAD scale involving forward and back-translation to and from Thai was conducted, and then the content validity index (CVI) of semantic equivalence was evaluated. The PAINAD-Th was tested on 120 videos of PwD. Each participant was recorded in two videos: one during an activity and the other at rest. Subsequently, two trained nurses independently observed the videos and rated the PAINAD-Th to assess inter-rater reliability. The rating process was repeated in one week to investigate the test-retest reliability. The concurrent validity was assessed against the Visual Analogue Scale rated by the expert committee. Results: The CVI of PAINAD-Th was 1.00 for forward translation and 0.93 for back translation. The PAINAD-Th showed strong correlations with the reference standard (rs=0.854–0.943, p-value <0.001). The inter-rater agreement for the total scores was 0.937 and 0.955, and the test-retest reliabilities were 0.914 to 0.964 for the activity stage and 0.880 for the resting stage, respectively. The concurrent validity index did not vary significantly across different stages of dementia; the findings remained consistent in the delirium subgroup analysis. Conclusions: The PAINAD-Th is a valuable tool for evaluating pain in PwD, not only in severe dementia but also in moderately severe stage, regardless of concurrent delirium. It also demonstrated good-to-excellent concurrent validity, inter-rater reliability, and test-retest reliability. https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/271644PainDementiaReproducibility of Results
spellingShingle Natthapapath Boonsawat
Patumporn Suraarunsumrit
Sutisa Pitiyarn
Napaporn Pengsorn
Varalak Srinonprasert
Sahatsa Mandee
Titima Wongviriyawong
Reliability and Validity of the Thai Version of the PAINAD Scale: An Extended Application of Pain Assessment in the Moderately Severe Stage of Dementia
Siriraj Medical Journal
Pain
Dementia
Reproducibility of Results
title Reliability and Validity of the Thai Version of the PAINAD Scale: An Extended Application of Pain Assessment in the Moderately Severe Stage of Dementia
title_full Reliability and Validity of the Thai Version of the PAINAD Scale: An Extended Application of Pain Assessment in the Moderately Severe Stage of Dementia
title_fullStr Reliability and Validity of the Thai Version of the PAINAD Scale: An Extended Application of Pain Assessment in the Moderately Severe Stage of Dementia
title_full_unstemmed Reliability and Validity of the Thai Version of the PAINAD Scale: An Extended Application of Pain Assessment in the Moderately Severe Stage of Dementia
title_short Reliability and Validity of the Thai Version of the PAINAD Scale: An Extended Application of Pain Assessment in the Moderately Severe Stage of Dementia
title_sort reliability and validity of the thai version of the painad scale an extended application of pain assessment in the moderately severe stage of dementia
topic Pain
Dementia
Reproducibility of Results
url https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/271644
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